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接受体外循环和非体外循环冠状动脉搭桥术患者术后房颤的发生率。

Incidence of postoperative atrial fibrillation in patients undergoing on-pump and off-pump coronary artery bypass grafting.

作者信息

Bohatch Júnior Milton Sérgio, Matkovski Paula Dayana, Di Giovanni Frederico José, Fenili Romero, Varella Everton Luz, Dietrich Anderson

机构信息

Universidade Regional de Blumenau, Blumenau, SC, BR.

Hospital Santa Isabel, Blumenau, SC, BR.

出版信息

Rev Bras Cir Cardiovasc. 2015 Jul-Sep;30(3):316-24. doi: 10.5935/1678-9741.20150040.

Abstract

OBJECTIVE

To determine the incidence of postoperative atrial fibrillation in patients undergoing on-pump and off-pump coronary artery bypass grafting.

METHODS

A retrospective study with analysis of 230 medical records between January 2011 and October 2013 was conducted.

RESULTS

Fifty-six (24.3%) out of the 230 patients were female. The average age of patients undergoing on-pump coronary artery bypass grafting was 59.91±8.62 years old, and off-pump was 57.16±9.01 years old (P=0.0213). The average EuroSCORE for the on-pump group was 3.37%±3.08% and for the off-pump group was 3.13%±3% (P=0.5468). Eighteen (13.43%) patients who underwent off-pump coronary artery bypass grafting developed postoperative atrial fibrillation, whereas for the onpump group, 19 (19.79%) developed this arrhythmia, with no significant difference between the groups (P=0.1955).

CONCLUSION

Off-pump coronary artery bypass grafting did not reduce the incidence of atrial fibrillation in the postoperative period. Important predictors of risk for the development of this arrhythmia were identified as: patients older than 70 years old and presence of atrial fibrillation in perioperative period in both groups, and non-use of beta-blockers drugs postoperatively in the on-pump group.

摘要

目的

确定接受体外循环和非体外循环冠状动脉搭桥术患者术后房颤的发生率。

方法

进行一项回顾性研究,分析2011年1月至2013年10月期间的230份病历。

结果

230例患者中有56例(24.3%)为女性。接受体外循环冠状动脉搭桥术患者的平均年龄为59.91±8.62岁,非体外循环患者为57.16±9.01岁(P=0.0213)。体外循环组的平均欧洲心脏手术风险评估系统(EuroSCORE)为3.37%±3.08%,非体外循环组为3.13%±3%(P=0.5468)。18例(13.43%)接受非体外循环冠状动脉搭桥术的患者发生了术后房颤,而体外循环组有19例(19.79%)发生了这种心律失常,两组之间无显著差异(P=0.1955)。

结论

非体外循环冠状动脉搭桥术并未降低术后房颤的发生率。该心律失常发生风险的重要预测因素被确定为:两组中年龄大于70岁的患者以及围手术期存在房颤,以及体外循环组术后未使用β受体阻滞剂药物。

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